During the fourth quarter of 2016, there were seven biweekly paydays on Friday (October 7, 21; November 4, 18; December 2, 16, 30) for Quality Repairs. Using the forms supplied on pages 4-44 to 4-47 (given below), complete the following for the fourth quarter:

a. Complete the Federal Deposit Information Worksheets reflecting electronic deposits (monthly depositor). The employer's phone number is (501) 555-7331. Federal deposit liability each pay, $677.68.

b. Employer's Quarterly Federal Tax Return, Form 941. The form is signed by you as president on January 31, 2017.

c. Employer's Report of State Income Tax Withheld for the quarter, due on or before January 31, 2017.

To be deposited on or before ______________

To be deposited on or before ______________

To be deposited on or before ______________

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Quarterly Payroll Data Total Earnings 5 Employees $18,750.00 OASDI HI FIT SIT 1,162.50 $271.88 1,875.00 $1,312.50 Employer's OASDI Employer's HI Federal deposit liability each pay 1,162.50 271.88 677.68 EMPLOYER'S REPORT OF STATE INCOME TAX WITHHELD 00-0-3301 DEC 20-- IF YOU ARE A SEA SONAL PLOYER AND THIS IS YOUR QUALITY REPAIRS 10 SUMMIT SQUARE CITY, STATE 00000-0000 THIS SEASON, CHEck OAND SHOW THE NEXT MONTH IN PAY WAGES SIGNATURE PERALT FEDERAL DEPOSIT INFORMATION WORKSHEET Employer Identification Number Month Tax Year Ends Type of Tax (Form) Address City, State, Zip 00-0004701 Name Amount of Deposit Tax Period Phone Number UA 1_ 10 SUMMIT SQUARE CITY, STATE 00000-0000 FEDERAL DEPOSIT INFORMATION WORKSHEET Employer Identification Number Month Tax Year Ends Type of Tax (Form) Address City, State, Zip 00-0004701 QUALITY REPAIRS Name Amount of Deposit Tax Period 12 10 SUMMIT SQUAREumber CITY, STATE 00000-0000 FEDERAL DEPOSIT INFORMATION WORKSHEET Employer Identification Number Month Tax Year Ends Type of Tax (Form) Address City, State, Zip 00-0004701 QUALITY REPAIRS Amount of Deposit Tax Period Phone Number 12 10 SUMMIT SQUARE CITY, STATE 00000-0000 Fom 941 for 20- Employer's QUARTERLY Federal Tax Return OMB No. 1545-0029 Report for this Quarter of 20- Chock ona Employaridantification numbar(EN amo not your trado namaQUALITY REPAIRS Trado namo pt any) Address 10 SuMMIT SQUARE : January, February, March 2:April, May, June 3 July, August, September 4 October, Novernber, December nstructions and prior year forms are CITY 00000-0000 Read the separate Instructions before you complate Form 941 Part 1: . Type or print within the boxes. Answer these for 1 Number of employees who recelved wages, tips, or other compensation for the pay period 2 3 4 including: Mar. 12 (Quarter 1), June 12 (Quarter 2), sept 12 (Quarter 31, or Dec. 12 (Quarter 4) Wages, tips, and other compensation Federal Income tax withheld trom wages, tips, and other compensation Ifno wages, tips, and other compensation are subject to social security or Medicare taxcheck and go to line 6. Column ㅓ Column 2 5a Taxable social security wages 5o Taxable social security tips 5c Taxable Medicare wages & tips 5d Taxable wages & tips subject to x.124- x.124- x029- Addltional Medicare Tax withholding x.009- 5e Add Column 2 from IInes 5a, 5b, 5c, and 5d 51 Section 3121(4) Notice and Demand-Tax due on unreported tips (see Instructions 6 Total taxes before adjustments. Add lines 3, Ee, and 5t 7 Current quarter's adjustment for fractions of cents 8 Current quarter's adjustment for sick pay 9 Current quarter's adjustments for tips and group-term Ilfe Insurance 0 Total taxes arter adjustments. Combine Ines 6 through 9 11 Total deposits for this quarter, Including overpayment applied from a prior quarter and 5e 5t 10 overpayments applied from Form 941-X 941-X (PR). 944-X, 944-x(PR), or 944-X (SP) ned In the current quarter 12 Balance due. It line 10 ls more than lne 11, enter the dierence and see Instructions 12 13 Overpayment. Ine 11 is more than Iine 10, enter the dimerence You MUST complete both pages of Form 941 and SIGN it. For Privacy Act and Paperwork Reduction Act Notioe, soe the baok of the Payment Vouchor.at No. 170012 Form 941 Rav. 1-2015 QUALITY REPAIRS 00-0004701 Part 2 Tell us about your deposit schedule and tax llablity for this quarter If you are unsure about whether you are a monthly schedule depositor or a semiweekly schedule depositor, see Circular E), section 11 14 Check one:Una 10 on this raturm Is lass han $2 500 or lina 10 on tho return for tha prior quartar was loss than $2 500, and you did not Incur a $100,000 next-day daposit obligation during the curront quartor. Ina 10 for tho prior quartar was lass than $2,500 but ine 10 on this rtu is $100,000 or mora, you must provida a racord of your tedaral tax labity. If you ฮาจ montly schedulo daposto, compl thg dapost chaduia below you aro a sa woakdy schodue dapostor, attach Sthadulo B Form 041 Go to Parta You were a monthly schedule depositor for the entire quarter. Enter your tax liability for each month and tota iability for the quarter, then go to Part 3. Tax liability Month1 Month 2 Month 3 Total liability for quarter Total must equal line 10. You were a semiweekly schedule depositor for any part of this quarter. Complete Schedule B (Form 941) Report of Tax Lability for Semiweekly Schedule Depositors, and attach it to Form 941. Part 3: Tell us about your business. It a question does NOT apply to your business, leave It blank If your business has closed or you stopped paying wages enter the final date you paid wages If you are a seasonal employer and you do not have to file a return for every quarter of the year 15 Check hare, and 16 Check here. Part 4 May we speak with your third-party designee? Do you want to allow an omployoo, a paid tax proparor, or another porson to discuss this roturn with theI for datais tha instructions Yes. Designee's name and phone number Seleat a 5-digit Personal Identification Number (PIN) to use when talking to the IRS □□□□□ No. Part 5: Sign here. You MUST complete both pages of Form 941 and SIGN It. Under ponatos of perוי. Ideclare that Ihawe aurnted this raturn, ncluding accompanyng schedule.nd si temants, and to the best of my know todge and bolof, It is true, coortoct and compliata Declaration of preparor (othor than taxpaor) Is barod on all information of which proparor has any knowladga. Print your name here Sign your name here Print your title here Date Best daytime phone Check if you are self-emplayed Praparor's nama Preparer's signature Firm's nama (or Date EN Address Phone City State AP codo Page Form 941 Rov. 1-2015)